House care trade hit by pandemic

The PHI National Workforce Data Center, a dropship research center, plans to have more than 341,000 vacancies in home health care in Pennsylvania by 2028.

February 16, 2021 | 8:09 a.m.

(Philadelphia) – Ray Wall would have preferred to wait a little before receiving the COVID-19 vaccine. He wanted to see how others would react to the shot before he got it himself. But as a nurse, the 47-year-old Philadelphian felt professionally obliged to get it as soon as possible. When notified that there was a place for him, he took it.

“I did it against my own belief and interests to want to wait,” said Wall on Jan. 29, a few hours after his first dose. “So I went in with a bit of mixed feelings, but ended up relying on what was right and that it should move on as soon as possible to get it.”

Wall is the primary nurse to Steven Sebastianelli, a 30-year-old with spinal muscle atrophy type 2. Wall spends up to 80 hours a week at his client’s home in Nicetown, Philadelphia. He takes care of medical needs and assists Sebastianelli with most activities of daily living such as positioning, feeding and dressing.

Wall and Sebastianelli have been a team for over a decade, but the pandemic has disrupted their daily lives.

Last April, the two candidates interviewed to join Sebastianelli’s round-the-clock rotation of nurses. Then Wall got sick with COVID-19.

“I was like oh, crap, I have COVID,” said Wall. “Which leads me to believe that maybe Steven had it too. Did i get it from him? Did he get it from me? Did we get it from one of the other nurses? “

Due to Wall’s illness and the subsequent quarantine, Sebastianelli had to rely on nurses. This worried the couple two things: finding nurses to cover Wall’s hours and wondering about the added risk of exposure.

“I’m not two,” said Wall. “There is no home care, there are no nurses waiting in the wings to fill a void when there is no nurse for a patient.”

And Sebastianelli was concerned about whether his nurses were exposed to the virus. “There is so much uncertainty about what is being put in that it leads to exhaustion,” he said.

If the vaccine rollout in the Pennsylvania Phase 1A and 1B combined distribution reaches home health workers, the chance for a vaccine will exist after nearly a year of additional care-related complications during the pandemic. For employees and customers, this is another wake-up call for longstanding problems in the industry.

The PHI National Workforce Data Center, a dropship research center, plans to have more than 341,000 vacancies in home health care in Pennsylvania by 2028.

As the need for home health care to care for the disabled and the aging population grows, the field is still grappling with low wages, education, transportation and high sales, said Philip McCallion, director and professor at the School of Social Work Temple University.

Additionally, workers often report feeling disrespected and not seen as essential caregivers like other health professionals, he said.

“We haven’t given this group, which is a very critical workforce, enough attention and respect for the really critical work they are doing,” McCallion added.

Home care workers take special care of particularly vulnerable population groups. They need to manage transportation between customers and worry about exposing themselves and their own families to the virus. For those with young children, the pandemic added another wrinkle.

Lisa DiMeo, owner of SYNERGY HomeCare in Center City, says many of her 50 home health care workers couldn’t cover shifts for customers because they couldn’t find childcare.

She says that created some kind of deficiency that she has not experienced before.

“We did our best not to give them too many seats, but it was definitely a situation where we had to go out of our way to handle these cases,” said DiMeo.

While it is not uncommon for home health workers to have multiple clients, during the pandemic the typical coordination around transportation and weighing different cases became another fear of exposure as workers visited different homes, apartment buildings and long-term care facilities.

For some in the field, the added pressure and risk meant their job was no longer worthwhile.

Jasmine Henderson, a 30-year-old housekeeper in West Philadelphia has a one-year-old son. Last summer, she stopped working in home health care after four years.

When she returned to the industry last fall, she asked her nursing agency to assign her to a person.

“Just one person because like I still have a whole family at home,” said Henderson. “So I’m not going from this house to this house, to this house, because you never know who was there before you. Has this person been tested? And only no. “

She started working with Altonya Sheppard, a 44-year-old social worker in southwest Philadelphia who has had at least three other house helpers since the pandemic began in March 2020.

(Left) Jasmine Henderson, 30, washes dishes in Altonya Sheppard’s kitchen. Henderson works as a household helper for Sheppard (44) in her house. (Madison Karas / WHY)

“I was a little hesitant at first because someone new was coming in because of the pandemic, but she came over here with a mask on and asked me if I had hand sanitizer and all that stuff, so I knew she was being pretty careful,” Sheppard said .

Lisa DiMeo hopes that some of the challenges related to ease of care coordination will exist as schools reopen and the vaccine rollout continues. Customers request vaccinated home helpers, and their staff will gradually be vaccinated after waiting for weeks.

“It just gets better and easier for us when this happens, and I was really nervous as I kept trying to get appointments and I was unable,” DiMeo said. “And I called the city and put the pressure on because we’re in Group 1A and we still haven’t been vaccinated, but I’ve now heard that several people have been given appointments, including me, so we’re looking a lot better now. “

Even so, McCallion hopes the pandemic will be a wake-up call to finally address the longstanding problems in this critical industry. Better wages, compensation for transportation between customers, and more opportunities for career advancement would be key.

“Your diligence means we don’t have to use more expensive alternatives. We should think about this as we think about appropriate levels of compensation as well as appropriate levels of education,” said McCallion.

For people like Sebastianelli, who is cared for at home for most of his life and continues to be cared for during and after the pandemic, he wants people to think critically about improving home health care.

“If there is a shortage, if there is this challenge, that when people care about people, how can we fix them?” Sebastianelli asked. “If there is a problem, how can we ask the questions people don’t ask?”

WHY is the premier public media broadcaster in the Philadelphia area including Delaware, South Jersey and Pennsylvania. This story originally appeared on

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